Monthly Literature Review

Size: px
Start display at page:

Download "Monthly Literature Review"

Transcription

1 Monthly Literature Review Perriman A, Leahy E, Semciw AI. The Effect of Open vs Closed Kinetic Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther Apr 23:1-52. doi: /jospt Review Submitted by: Sarah Bosserman, PT, DPT, CSCS Objective: Primary aim was to determine if OKC quadriceps exercises resulted in differences in anterior laxity when compared to CKC exercises at any time point following ACL reconstruction. Secondary aim was to determine if there was a difference in strength, function, quality of life and adverse events with OKC vs CKC quadriceps exercises at any time point. Methods: Seven electronic databases were searched in April RCTs that compared OKC and CKC quadriceps exercises for post op ACL-R patients were included. Outcomes had to include anterior tibial laxity (measured by arthrometry), lower limb strength, function, or quality of life. Data was grouped according to outcome and time-point follow up, for both early (<6 weeks) and late (>6 weeks) introduction of OKC exercises. Time-points for follow up where short term (<12 weeks), medium term (3-6 months), long term (6-12 months), and very long term (>12 months). Results were synthesized using meta-analysis and the GRADE approach. Results: A total of 10 studies were eligible for review with a total of 494 participants. Mean age ranged from years old and majority male (74%). Five were patellar graft studies, two hamstring graft studies, two included both, and one did not specify. For early addition of OKC, meta-analysis demonstrated low-moderate evidence of no increase in risk of having clinically meaningful laxity, regardless of intervention, across all time points. It was shown that there was a slight increase in laxity in the OKC groups, particularly for the hamstring graft, however, pooled differences were not statistically significant and between group differences were <2mm clinical laxity threshold. For late addition of OKC, there was limited evidence of no between group differences in laxity at medium and long term follow up. Lowmoderate evidence from two studies showed no between group differences in strength outcomes at any time point with early introduction of OKC exercises vs CKC exercises. It was also found that there was low-moderate evidence of no between group differences in patient reported functional outcomes with early addition of OKC. Conclusions: Considering all graft types, there was low-moderate evidence from three studies that there are no between group differences in laxity at any time point, when early OKC exercises are introduced compared to CKC exercises. For quad strength, functional outcomes, and physical function tests, there was limited to moderate quality evidence to demonstrate no between group differences at any time point with addition of OKC exercises before 6 weeks compared to CKC exercises. Commentary: Although the pooled results showed no significant differences between groups, there did seem to be more inconsistency when studies were looking at hamstring vs patellar grafts. One study found greater laxity (Heijne et al) in OKC vs CKC exercises, while another found no differences (Fukuda et al). The study finding no differences used a more conservative protocol and progression of ROM that may suggest specific ranges for OKC exercises are safer than others for hamstrings grafts, however more research is needed. Further, the early addition of OKC exercises did not seem to provide a significant increase in strength and/or function over late addition OKC exercises. Clinically, considering graft

2 type and patient goals may be beneficial in deciding the best of treatment (i.e. are they a soccer player that needs strength in OKC, etc.). Limitations of the systematic review, including a mostly male population and the relatively small number of trials and sample sizes make this less generalizable to all patients. Furthermore, heterogeneity in graft type, interventions, and outcomes addressed limited the ability to complete meta-analyses. Future research investigating adverse events (vs laxity alone) and long term physical function outcomes may provide more meaningful information to the clinician.

3 Citation: Fernandes S, Parekh M, Moses J, Fuller C, Scammell B, Batt E et al. Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared with men in general population: a cross- sectional study. Br J Sports Med, 2018;52: Review submitted by: Jennifer M. Boyle Objective: 1) To determine the prevalence of knee osteoarthritis outcomes (knee pain, RKOA, CC and requirement for TKR) and risk factors for kne OA for retired male football players vs in the general male population. 2) To compare prevalence of the outcome measures selected in ex football players and the general population. 3) Determine the main risk factors for any increased prevalence in knee OA outcomes in ex football players. Methods: Cross sectional designed study utilizing questionnaires to ex- football players (inclusion criteria: > 40 y/o and played professionally) and men in the general population (inclusion criteria: > 40 y/o, not terminally ill and were able to give written consent). Information on knee pain, surgery and KOA risk factors including demographics, occupation, general health and current medications were taken into account. Those who consented underwent bilateral knee radiographs to determine RKOA and CC. Radiographs performed in wbing semi flexed, posterior anterior and 30 degrees flex skyline views). Results: 4775 questionnaires were sent out to ex football players and 1207 responses were received. 40, 000 were sent to the general population and 4085 of men were returned completed. Over all prevalence of knee pain according to the questionnaire in ex football players was 52.2% compared with 26.9% of the general population. Ex football players also had more current knee pain then the general population. Radiographic findings show the RKOA in ex football players to be 64% and in the general population 35.2%. They also found that in ex football players they had a higher prevalence of R > L RKOA. Conclusions: The prevalence of knee osteoarthritis outcomes (knee pain questionnaire, RKOA and TKR) are 2-3 times greater in make ex- football platers in comparison to the general male population. Commentary: Football (soccer) was stated to be the most popular team sport world wide according to this article. If playing professionally it has been seen to have a 17% injury rate of the knee. It was stated that the repetitive micro trauma and joint overloading could further lead to degeneration of the knee joint and lead to knee osteoarthritis. Further understanding the prevalence of how much more football and other sports can have long lasting effects on people knee health is very valuable. This information helps us as clinicians emphasize the importance of proper care and pre/post rehabilitation to these athletes knees at a younger age. If we are able to start picking out populations that are at a predisposition to these injuries later in life (aka football players for knee OA) then we can implement rehabilitation programs earlier in their career to give them a fighting chance to avoid injures later in life.

4 Effect of physical exercise on musculoskeletal pain in multiple body regions among healthcare workers: Secondary analysis of a cluster randomized controlled trial. Jacobsen M D, et al. Musculoskeletal Science and Practice. April Vol 34. Pgs Submitted by: Justin Pretlow PT, DPT, OCS Objective: To evaluate the effect of workplace versus home-based physical exercise on pressure pain threshold(ppt) and musculoskeletal pain intensity in multiple body regions among healthcare workers. Methods: Study design: a two-armed parallel-group, single-blind, cluster randomized controlled trial with allocation concealment. Two-hundred female healthcare workers from 18 departments at three hospitals were cluster-randomized to 10 weeks of: 1) home-based physical exercise (HOME) performed alone during leisure time for 5 10 min per week or 2) workplace physical exercise (WORK) performed in groups during working hours for 5 10 min per week and up to 5 motivational coaching sessions. PPT (neck, lower back, lower leg) and perceived pain intensity in multiple body regions (feet, knee, hips, lower and upper back, elbow, hand, shoulder, neck, and head) were measured at baseline and 10-week follow-up Results: In some of the body regions, PPT and pain intensity improved more following WORK than HOME. Between-group differences at follow-up (WORK vs. HOME) were 41 kpa [95% CI 13 70, effect size (ES): 0.22] for PPT in the lower back, and 0.7 [95% CI , ES: 0.26] and 0.6 points [95% CI , ES: 0.23] for pain intensity in the lower back and feet(vas), respectively. HOME did not improve more than WORK for any of the measurements. Conclusions: Performing supervised group-based physical exercise with motivational coaching sessions during working hours is more effective than exercising alone at home in improving pressure pain threshold in the lower back and reducing musculoskeletal pain in the lower back and feet among healthcare workers. Companies aiming at improving employee health may consider offering daily physical exercises and motivational coaching sessions at work as it is accompanied by higher training adherence and improved pain compared to encouraged home-based exercise. Commentary: The authors concluded that physical exercise at the workplace was more effective than home-based exercise in improving pressure pain threshold in the lower back. I like the idea of a workplace exercise program being beneficial but there are some significant limitations to this study. The average adherence to exercise was over 2 sessions per week for Work based and approximately 1 session a week for Home based. The exercise routine for Work-based included 10 exercises utilizing kettlebells, swissballs, and elastic bands. The Work based group performed a circuit of 4-6 exercises out of 10 each session. The Home based routine utilized elastic bands only with a poster of 10 exercises in which participants were instructed to pick 4 for each training session. Safety concerns were cited as a reason kettlebell exercise were not assigned to the Home based group. The authors could have offered training sessions to the Home based group initially or at intervals if they wanted to make the interventions somewhat comparable. The inclusion of motivational coaching sessions for the Work based group likely has a large impact on the results, but that effect cannot be quantified with only 1 group receiving motivational coaching. I think the limitations of this study outweigh any strengths. In short, it appears they offered the work based group a greater variety of exercises, proper training with an instructor, and motivational coaching sessions while the home based group received a few elastic bands and a poster illustrating 10 exercises. It s not surprising that the work based group showed greater changes in pressure pain threshold and VAS pain ratings.

5 Andrews, Dawn P. et al. "THE UTILIZATION OF MULLIGAN CONCEPT THORACIC SUSTAINED NATURAL APOPHYSEAL GLIDES ON PATIENTS CLASSIFIED WITH SECONDARY IMPINGEMENT SYNDROME: A MULTI-SITE CASE SERIES." International Journal of Sports Physical Therapy 13.1 (2018): Web. Review Submitted by: Katie Long, PT, DPT Objective: To explore the effects of one thoracic Mulligan Concept SNAG treatment session on individuals classified with subacromial impingement syndrome, while utilizing a classification-based treatment protocol Methods: Patients met the study inclusion criteria if they met the Boyles et al. classificationbased criteria of reporting greater than 2/10 on the NRPS during Neer s impingement sign, Hawkins impingement sign, active shoulder abduction, resisted IR, resisted ER and empty can testing. Patients were excluded if their primary complaint was neck or thoracic pain, if they demonstrated neurological deficit, had a positive spurling s test, received mobilization to the glenohumeral joint or thoracic spine within last 30 days, received CSI within 30 days. The SNAG assessment was provided by the clinician identifying the painful or restricted vertebral level and applying an PA cephalad glide with the ulnar aspect of their hand. The patient then extended their trunk over the clinician s hand. A maximum of three consecutive vertebral levels were assessed for a pain-free response to guide intervention location. Treatment was directed at the identified vertebral level and included instructing the patient to extend their trunk over the clinician s hand for 3 sets of 10 repetitions with 1 minute rest breaks in between. Outcome measures included NRPS, SPADI and shoulder AROM taken at initial evaluation, immediately post-treatment and at 48-hours post-treatment. Results: No significant differences in NRPS scores during Hawkins impingement test and Neer impingement test from initial, immediate follow up and 28-hour follow up. Patients reported significant improvements in NRPS during resisted shoulder resisted ER testing between initial and post-treatment testing as well as significant improvements from initial to 48-hour follow up testing. Patients achieved a statistical decrease in SPADI scores from initial assessment to 48-hour follow up, however this score was not clinically significant. SNAG intervention did not produce significant differences in overall shoulder ROM throughout assessment measures, although shoulder ER and flexion demonstrated moderate effect sizes. Conclusions: The results of this study show that the use of thoracic SNAGs in patients classified with subacromial impingement syndrome may be beneficial in short-term pain and disability. However, the results found in this study did not meet clinically meaningful differences for several hypothesized reasons. The authors indicate that their results may be different from the Boyles et al. study due to patient chronicity of symptoms, as the patients in this study had symptoms less than 30 days. The intervention of this study was targeted at one spinal segment, however the previous study protocol targeted three spinal levels with HLVA. The authors also postulate that the results of this study may have had greater effects on pain and disability if manual therapy directed at the glenohumeral joint had been added. Commentary: This study utilizes concepts from several previously established articles supporting the use of intervention to the thoracic spine in those with shoulder dysfunction by applying the regional independence model. The results of this study show that while a single session of thoracic SNAGs may be beneficial in reducing pain and dysfunction, I believe it is crucial to consider additional interventions to the thoracic spine as well as manual treatment to the local impairments. This study s results may be useful in those with high pain and disability as a way to decrease irritability in order to perform more local interventions to the glenohumeral joint. It may also be useful in application to those whom may be

6 contraindicated for the use of HLVA intervention. As addressed as a limitation of this study, a single dose of intervention was all that was applied in these patients and there may be more significant effects if multiple sessions of treatment interventions had been applied.

7 Kim YS, Lee HJ, Kim JH, Noh DY. When Should We Repair Partial-Thickness Rotator Cuff Tears? Outcome Comparison Between Immediate Surgical Repair Versus Delayed Repair After 6-Month Period of Nonsurgical Treatment. Am J Sports Med. 2018;46(5): Review Submitted By: Tyler France, PT, DPT, CSCS Objective: The purpose of this study is to compare the results of immediate arthroscopic rotator cuff repair with repair after 6 months of non-operative care of partial thickness rotator cuff tears (PTRCTs) involving >50% of the tendon thickness. Methods: The authors of this study prospectively randomized and analyzed 78 consecutive patients with either isolated bursal-side or articular-side partial thickness supraspinatus tears. Group 1 (n=44) received immediate rotator cuff repair. Group 2 (n=34) received delayed rotator cuff repair after 6 months of non-operative treatment including activity modification, NSAIDs, corticosteroid injections, and physical therapy. The American Shoulder and Elbow Surgeons (ASES) Score, Constant score, visual analog scale for pain, and ROM at initial visit; months 3, 6, and 12 post-operatively; and the last visit after 24 months were used for the evaluation. Cuff integrity was assessed with magnetic resonance imaging at 12 months post-operatively. Results: There were no significant differences in age, sex, symptom duration, composition of PTRCTs, or clinical outcomes between Groups 1 and 2 at 24 months. In group 2, 10 patients voluntarily dropped out from the study due to improvement of symptoms during the 6 month non-operative treatment period. At the end of the study, both groups showed significant improvements in terms of functional scores and VAS scores compared to the initial period. There were no significant differences between the two groups, except for lower pain VAS score and higher ASES score in group 2 at 6 months post-operatively. At 12 months postoperatively, 1 patient from group 1 and 2 patients from group 2 had experienced a retear. Conclusions: Both immediate surgical repair and delayed surgical repair with conservative treatments were effective in improving clinical outcomes, and there was a similarly low incidence of retears in both groups. However, at 6 months post-operatively, superior functional outcomes were observed in the delayed repair group compared with the immediate repair group. A trial period of pre-operative non-surgical care is reasonable, and immediate surgical repair is not crucial for the treatment of PTRCT. Commentary: This study puts forth information that can help to encourage trials of nonoperative care for patients with PTRCTs rather than jumping into surgery. There seems to be clear consensus that the surgery should be performed if the tear continues to progress and if pain and functional disability continue to become worse. However, there is no real consensus on how to manage patients with progressing pain and disability but no increase in tear size, or in asymptomatic patients with progressing tears. This article seems to indicate that preoperative management should be attempted before operating on PTRCTs.

Review Submitted By: Tyler France, PT, DPT, CSCS

Review Submitted By: Tyler France, PT, DPT, CSCS Webster KE, Nagelli CV, Hewett TE, Feller JA. Factors Associated With Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery. Am J Sports Med. 2018;46(7):1545-1550.

More information

Review Submitted by: Katie Long, PT, DPT

Review Submitted by: Katie Long, PT, DPT Added, Marco Aurélio N. et al. "STRENGTHENING THE GLUTEUS MAXIMUS IN SUBJECTS WITH SACROILIAC DYSFUNCTION". International Journal Of Sports Physical Therapy, vol 13, no. 1, 2018, pp. 114-120. The Sports

More information

The Society for Patient Centered Orthopedics. Choosing Wisely List. James Rickert, MD 1

The Society for Patient Centered Orthopedics. Choosing Wisely List. James Rickert, MD 1 The Society for Patient Centered Orthopedics Choosing Wisely List James Rickert, MD 1 Extremities and Trauma Vertebroplasty Rotator Cuff Repair: For atraumatic (degenerative) tears in patients greater

More information

Preliminary Report Choosing Wisely Identifying Musculoskeletal Interventions with Limited Levels of Efficacy in the Shoulder & Elbow.

Preliminary Report Choosing Wisely Identifying Musculoskeletal Interventions with Limited Levels of Efficacy in the Shoulder & Elbow. Preliminary Report Choosing Wisely Identifying Musculoskeletal Interventions with Limited Levels of Efficacy in the Shoulder & Elbow. Prepared for The Canadian Orthopaedic Association Contents Executive

More information

ROTATOR CUFF DISORDERS/IMPINGEMENT

ROTATOR CUFF DISORDERS/IMPINGEMENT ROTATOR CUFF DISORDERS/IMPINGEMENT Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery, SPARSH

More information

ACL+Blood Flow Restriction Part 2

ACL+Blood Flow Restriction Part 2 ACL+Blood Flow Restriction Part 2 In the previous email, we discussed the first 2 weeks of recovery from ACL surgery and the potential effects of cell swelling via Blood Flow Restriction to mitigate atrophy.

More information

Evaluation of the Knee and Shoulder

Evaluation of the Knee and Shoulder Evaluation of the Knee and Shoulder Karen J. Boselli, MD Northeast Regional Nurse Practitioner Conference May 2018 Knee Overview History Examination Top 5 diagnoses When to image When to refer Pain most

More information

Mastering the Musculoskeletal Exam UCSF Essentials of Women s Health July 7, 2016 Carlin Senter, M.D. Henry Crevensten, M.D.

Mastering the Musculoskeletal Exam UCSF Essentials of Women s Health July 7, 2016 Carlin Senter, M.D. Henry Crevensten, M.D. Mastering the Musculoskeletal Exam UCSF Essentials of Women s Health July 7, 2016 Carlin Senter, M.D. Henry Crevensten, M.D. I have nothing to disclose Outline Knee exam Shoulder exam Knee Anatomy The

More information

Survey Results. Survey Results. What we will cover today? An evidence-based approach to rotator cuff disease

Survey Results. Survey Results. What we will cover today? An evidence-based approach to rotator cuff disease Survey Results An evidence-based approach to rotator cuff disease Brian Feeley, MD UCSF Sports Medicine What questions can we answer for you about rotator cuff problems? 1. How to do a good exam (5) 2.

More information

The Effectiveness of Injury-Prevention Programs in Reducing the Incidence of Anterior Cruciate Ligament Sprains in Adolescent Athletes

The Effectiveness of Injury-Prevention Programs in Reducing the Incidence of Anterior Cruciate Ligament Sprains in Adolescent Athletes Critically Appraised Topics Journal of Sport Rehabilitation, 2012, 21, 371-377 2012 Human Kinetics, Inc. The Effectiveness of Injury-Prevention Programs in Reducing the Incidence of Anterior Cruciate Ligament

More information

TREATMENT GUIDELINES FOR GRADE 3 PCL TEAR

TREATMENT GUIDELINES FOR GRADE 3 PCL TEAR GENERAL CONSIDERATIONS Posterior cruciate ligament (PCL) injuries occur less frequently than anterior cruciate ligament (ACL) injuries, but are much more common than previously thought. The PCL is usually

More information

REHABILITATION GUIDELINES FOR ROTATOR CUFF REPAIR FOR TYPE II TEARS (MASSIVE)(+/- SUBACROMIAL DECOMPRESSION)

REHABILITATION GUIDELINES FOR ROTATOR CUFF REPAIR FOR TYPE II TEARS (MASSIVE)(+/- SUBACROMIAL DECOMPRESSION) REHABILITATION GUIDELINES FOR ROTATOR CUFF REPAIR FOR TYPE II TEARS (MASSIVE)(+/- SUBACROMIAL DECOMPRESSION) The rehabilitation guidelines are presented in a criterion based progression. General time frames

More information

OMICS - 3rd Int. Conference & 2

OMICS - 3rd Int. Conference & 2 KNEE OBJECTIVE STABILITY AND ISOKINETIC THIGH MUSCLE STRENGTH AFTER ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION: A Randomized Six-Month Follow-Up Study M. Sajovic Department of Orthopedics and Sports

More information

Effectiveness Of Manual Physical Therapy For Painful Shoulder Conditions A Systematic Review

Effectiveness Of Manual Physical Therapy For Painful Shoulder Conditions A Systematic Review Effectiveness Of Manual Physical Therapy For Painful Shoulder Conditions A Systematic Review Keeping Manual Physical Therapy In Effectiveness Manual Therapy of manual physical therapy for painful shoulder

More information

EXERCISE PRESCRIPTION PART 1

EXERCISE PRESCRIPTION PART 1 EXERCISE PRESCRIPTION PART 1 Michael McMurray, PT, DPT, OCS, FAAOMPT Orthopaedic Manual Physical Therapy Series Charlottesville 2017-2018 What is MET? An active rehabilitation system based in the biopsychosocial

More information

ACUTE EFFECTS OF DIFFERENT ANTERIOR THIGH SELF-MASSAGE ON HIP RANGE-OF-MOTION IN TRAINED MEN. Monteiro ER. Int J Sports Phys Ther.

ACUTE EFFECTS OF DIFFERENT ANTERIOR THIGH SELF-MASSAGE ON HIP RANGE-OF-MOTION IN TRAINED MEN. Monteiro ER. Int J Sports Phys Ther. ACUTE EFFECTS OF DIFFERENT ANTERIOR THIGH SELF-MASSAGE ON HIP RANGE-OF-MOTION IN TRAINED MEN. Monteiro ER. Int J Sports Phys Ther. 2018 Feb;13(1):104-113. Review submitted by: Justin Pretlow, PT, DPT,

More information

Musculoskeletal Annotated Bibliography

Musculoskeletal Annotated Bibliography Musculoskeletal Annotated Bibliography Clinical Question: Is Kinesio taping effective in improving ROM and/or pain in the treatment of shoulder injuries? Thelen MD, Dauber JA, Stoneman PD. The clinical

More information

Review shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of

Review shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of Review shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of chronic shoulder pain Review with some case questions Bones:

More information

ACL Reconstruction Protocol (Allograft)

ACL Reconstruction Protocol (Allograft) ACL Reconstruction Protocol (Allograft) Week one Week two Initial Evaluation Range of motion Joint hemarthrosis Ability to contract quad/vmo Gait (generally WBAT in brace) Patella Mobility Inspect for

More information

Anterior Cruciate Ligament (ACL) Rehabilitation

Anterior Cruciate Ligament (ACL) Rehabilitation Thomas D. Rosenberg, M.D. Vernon J. Cooley, M.D. Anterior Cruciate Ligament (ACL) Rehabilitation Dear Enclosed you will find a copy of our Anterior Cruciate Ligament (ACL) Rehabilitation program and the

More information

Appendix 2: KNGF Evidence Statement for anterior cruciate ligament reconstruction rehabilitation

Appendix 2: KNGF Evidence Statement for anterior cruciate ligament reconstruction rehabilitation Appendix 2: KNGF Evidence Statement for anterior cruciate ligament reconstruction rehabilitation Inclusion and exclusion criteria for rehabilitation according to the Evidence Statement Inclusion of patients

More information

ACL Athletic Career. ACL Rupture - Warning Features Intensive pain Immediate swelling Locking Feel a Pop Dead leg Cannot continue to play

ACL Athletic Career. ACL Rupture - Warning Features Intensive pain Immediate swelling Locking Feel a Pop Dead leg Cannot continue to play FIMS Ambassador Tour to Eastern Europe, 2004 Belgrade, Serbia Montenegro Acute Knee Injuries - Controversies and Challenges Professor KM Chan OBE, JP President of FIMS Belgrade ACL Athletic Career ACL

More information

REHABILITATION GUIDELINES FOR ANTERIOR SHOULDER RECONSTRUCTION WITH BANKART REPAIR

REHABILITATION GUIDELINES FOR ANTERIOR SHOULDER RECONSTRUCTION WITH BANKART REPAIR REHABILITATION GUIDELINES FOR ANTERIOR SHOULDER RECONSTRUCTION WITH BANKART REPAIR The rehabilitation guidelines are presented in a criterion based progression. General time frames are given for reference

More information

REHABILITATION GUIDELINES FOR ARTHROSCOPIC CAPSULAR SHIFT

REHABILITATION GUIDELINES FOR ARTHROSCOPIC CAPSULAR SHIFT REHABILITATION GUIDELINES FOR ARTHROSCOPIC CAPSULAR SHIFT The rehabilitation guidelines are presented in a criterion based progression. General time frames are given for reference to the average, but individual

More information

Rehabilitation Guidelines for Large Rotator Cuff Repair

Rehabilitation Guidelines for Large Rotator Cuff Repair Rehabilitation Guidelines for Large Rotator Cuff Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the

More information

Principles of Treatment. Case Studies. Principles of Treatment. Clinical Perspectives for the GP

Principles of Treatment. Case Studies. Principles of Treatment. Clinical Perspectives for the GP Principles of Treatment Clinical Perspectives for the GP Case Studies 1. Jumping athlete with an acute exacerbation of chronic patellar tendinopathy major competition in 9 days time 2 week tournament 2.

More information

Breakout Session #7: Manual therapy for shoulder pain and limited mobility

Breakout Session #7: Manual therapy for shoulder pain and limited mobility Northwestern University Feinberg School of Medicine Breakout Session #7: Manual therapy for shoulder pain and limited mobility @Amee_S Objectives 1. Demonstrate the examination procedures and describe

More information

Female Athlete Injury Prevention

Female Athlete Injury Prevention Female Athlete Injury Prevention Startling Facts Huge rise in knee ligament injuries among young females engaging in sport and exercise Females athletes participating in jumping and pivoting sports are

More information

Rotator Cuff Repair Outcomes. Patrick Birmingham, MD

Rotator Cuff Repair Outcomes. Patrick Birmingham, MD Rotator Cuff Repair Outcomes Patrick Birmingham, MD Outline Arthroscopic Vs. Mini-open Subjective Outcomes Objective Outcomes Timing Arthroscopic Vs. Mini-open Sauerbrey Arthroscopy 2005 Twenty-six patients

More information

Accelerated Rehabilitation Following ACL-PTG Reconstruction & PCL Reconstruction with Medial Collateral Ligament Repair

Accelerated Rehabilitation Following ACL-PTG Reconstruction & PCL Reconstruction with Medial Collateral Ligament Repair Page 1 of 7 Accelerated Rehabilitation Following ACL-PTG Reconstruction & PCL Reconstruction with Medial Collateral Ligament Repair PREOPERATIVE PHASE Goals: Diminish inflammation, swelling, and pain Restore

More information

The Shoulder. Jennifer R Marks, MD

The Shoulder. Jennifer R Marks, MD The Shoulder Jennifer R Marks, MD Shoulder Anatomy Skeletal & ligamentous components: The joint is comprised of a confluence of Scapula Clavicle Humerus https://www.shoulderdoc.co.uk/article/ http/ www.shoulderdoc.co.uk/article/117777

More information

REHABILITATION GUIDELINES FOR SUBSCAPULARIS (+/- SUBACROMIAL DECOMPRESSION) Dr. Carson

REHABILITATION GUIDELINES FOR SUBSCAPULARIS (+/- SUBACROMIAL DECOMPRESSION) Dr. Carson REHABILITATION GUIDELINES FOR SUBSCAPULARIS (+/- SUBACROMIAL DECOMPRESSION) Dr. Carson The rehabilitation guidelines are presented in a criterion based progression. General time frames are given for reference

More information

Anterior Cruciate Ligament (ACL) Injuries

Anterior Cruciate Ligament (ACL) Injuries Anterior Cruciate Ligament (ACL) Injuries Mark L. Wood, MD The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. The incidence of ACL injuries is currently estimated

More information

Post Operative Knee Rehab: Return to Play after ACLR

Post Operative Knee Rehab: Return to Play after ACLR Post Operative Knee Rehab: Return to Play after ACLR Fall Session 2016 Mary Lloyd Ireland, M.D. Associate Professor University of Kentucky Dept. of Orthopaedic Surgery & Sports Medicine, Lexington, KY

More information

11/13/2017. Disclosures: The Irreparable Rotator Cuff. I am a consultant for Arhtrex, Inc and Endo Pharmaceuticals.

11/13/2017. Disclosures: The Irreparable Rotator Cuff. I am a consultant for Arhtrex, Inc and Endo Pharmaceuticals. Massive Rotator Cuff Tears without Arthritis THE CASE FOR SUPERIOR CAPSULAR RECONSTRUCTION MICHAEL GARCIA, MD NOVEMBER 4, 2017 FLORIDA ORTHOPAEDIC INSTITUTE Disclosures: I am a consultant for Arhtrex,

More information

Physical Examination of the Shoulder

Physical Examination of the Shoulder General setup Patient will be examined in both the seated and supine position so exam table needed 360 degree access to patient Expose neck and both shoulders (for comparison); female in gown or sports

More information

Knee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain

Knee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain Knee Injuries PSK 4U Mr. S. Kelly North Grenville DHS Medial Collateral Ligament Sprain Result from either a direct blow from the lateral side in a medial direction or a severe outward twist Greater injury

More information

Diagnostic and Management Approach to the Painful Shoulder

Diagnostic and Management Approach to the Painful Shoulder Diagnostic and Management Approach to the Painful Shoulder Introduction What conditions causing shoulder pain commonly present in General Practice? Subacromial impingement Rotator cuff tears AC joint pathology

More information

ACL Rehabilitation and Return To Play

ACL Rehabilitation and Return To Play ACL Rehabilitation and Return To Play Seth Gasser, MD Director of Sports Medicine Florida Orthopaedic Institute Introduction Return to Play: the point in recovery from an injury when a person is safely

More information

Thoracic Spine Mobilization for Shoulder Pain. Scott Tauferner PT, ATC

Thoracic Spine Mobilization for Shoulder Pain. Scott Tauferner PT, ATC Thoracic Spine Mobilization for Shoulder Pain Scott Tauferner PT, ATC Conflicts of Interest None 1 2 3 Participants will be able to select thoracic mobilization strategies in patients with shoulder pain.

More information

Anterior Stabilization of the Shoulder: Distal Tibial Allograft

Anterior Stabilization of the Shoulder: Distal Tibial Allograft Anterior Stabilization of the Shoulder: Distal Tibial Allograft Name: Diagnosis: Date: Date of Surgery: Phase I Immediate Post Surgical Phase (approximately Weeks 1-3) Minimize shoulder pain and inflammatory

More information

Shoulder Case Studies

Shoulder Case Studies Shoulder Case Studies Eden Raleigh Orthopaedic Surgeon Shoulder & Knee Surgery Ph: 9421 1900 0402697115 dredenraleigh@gmail.com My Background Specialising in Shoulder and Knee Surgery Main focus on Arthroscopic/Sports

More information

/ 50 possible = ATPE 412 Exam #3 - Spring 05

/ 50 possible = ATPE 412 Exam #3 - Spring 05 ATPE 412 Exam #3 - Spring 05 CASE STUDY Big Bubba tore his ACL and anterior-lateral meniscus of his right knee on April 1 st of 2005. He had surgery on April 25 th using a patellar tendon autograft and

More information

Clinical Case Series (vs. Case Study) Patient #1 Progression Male Soccer Athlete 5/26/2016

Clinical Case Series (vs. Case Study) Patient #1 Progression Male Soccer Athlete 5/26/2016 Patellar Chondroplasty With Gel-One Cross-Linked Hyaluronate Injection for the Treatment of Grade III Patellar Chondromalacia in Collegiate Male Athletes: A Case Series David Tomchuk, MS, ATC, LAT, CSCS

More information

When Clinical Reasoning Overrules the Evidence

When Clinical Reasoning Overrules the Evidence When Clinical Reasoning Overrules the Evidence Breakout session Paul Mintken PT, DPT, OCS, FAAOMPT Kristin Carpenter PT, DPT, OCS, FAAOMPT Amy McDevitt PT, DPT, OCS, FAAOMPT Objectives Break Out Session

More information

Anterior Cruciate Ligament (ACL) Reconstruction Protocol. Hamstring Autograft, Allograft, or Revision

Anterior Cruciate Ligament (ACL) Reconstruction Protocol. Hamstring Autograft, Allograft, or Revision Anterior Cruciate Ligament (ACL) Reconstruction Protocol Hamstring Autograft, Allograft, or Revision As tolerated should be understood to perform with safety for the reconstruction/repair. Pain, limp,

More information

Anterior Cruciate Ligament Injuries

Anterior Cruciate Ligament Injuries Anterior Cruciate Ligament Injuries One of the most common knee injuries is an anterior cruciate ligament sprain or tear.athletes who participate in high demand sports like soccer, football, and basketball

More information

PHASE I (Begin PT 3-5 days post-op) DOS:

PHASE I (Begin PT 3-5 days post-op) DOS: REHABILITATION GUIDELINES FOR POSTERIOR SHOULDER RECONSTRUCTION +/- LABRAL REPAIRS The rehabilitation guidelines are presented in a criterion based progression. General time frames are given for reference

More information

Rehabilitation Guidelines for Anterior Cruciate Ligament (ACL) Reconstruction

Rehabilitation Guidelines for Anterior Cruciate Ligament (ACL) Reconstruction Rehabilitation Guidelines for Anterior Cruciate Ligament (ACL) Reconstruction The knee is the body's largest joint, and the place where the femur, tibia, and patella meet to form a hinge-like joint. These

More information

ACL and Knee Injury Prevention. Presented by: Zach Kirkpatrick, PT, MPT, SCS

ACL and Knee Injury Prevention. Presented by: Zach Kirkpatrick, PT, MPT, SCS ACL and Knee Injury Prevention Presented by: Zach Kirkpatrick, PT, MPT, SCS ACL Anatomy ACL Mechanism of Injury Contact ACL Tear Noncontact ACL Tear ACL MOI and Pathology Common in young individual who

More information

REHABILITATION GUIDELINES FOR ROTATOR CUFF REPAIR FOR TYPE I TEARS (+/- SUBACROMINAL DECOMPRESSION)

REHABILITATION GUIDELINES FOR ROTATOR CUFF REPAIR FOR TYPE I TEARS (+/- SUBACROMINAL DECOMPRESSION) REHABILITATION GUIDELINES FOR ROTATOR CUFF REPAIR FOR TYPE I TEARS (+/- SUBACROMINAL DECOMPRESSION) The rehabilitation guidelines are presented in a criterion based progression. General time frames are

More information

Shoulder Instability and Tendon Injuries

Shoulder Instability and Tendon Injuries Shoulder Instability and Tendon Injuries Shoulder Update Spire Hospital Leeds November 2017 Simon Boyle Consultant Shoulder and Elbow Surgeon Simon Boyle York and Leeds Nuffield Trained in Yorkshire, Annecy,

More information

A Patient s Guide. ACL Injury: Ø Frequently asked questions on injury, Ø Preoperative and postoperative. surgery and recovery.

A Patient s Guide. ACL Injury: Ø Frequently asked questions on injury, Ø Preoperative and postoperative. surgery and recovery. ACL Injury: A Patient s Guide Ø Frequently asked questions on injury, surgery and recovery Ø Preoperative and postoperative guidelines Mia S. Hagen, M.D. Assistant Professor Department of Orthopaedics

More information

What is an ACL Tear?...2. Treatment Options...3. Surgical Techniques...4. Preoperative Care...5. Preoperative Requirements...6

What is an ACL Tear?...2. Treatment Options...3. Surgical Techniques...4. Preoperative Care...5. Preoperative Requirements...6 Table of Contents What is an ACL Tear?....2 Treatment Options...3 Surgical Techniques...4 Preoperative Care...5 Preoperative Requirements...6 Postoperative Care...................... 7 Crutch use...8 Initial

More information

UNUSUAL ACL CASE: Tibial Eminence Fracture in a Female Collegiate Basketball Player

UNUSUAL ACL CASE: Tibial Eminence Fracture in a Female Collegiate Basketball Player UNUSUAL ACL CASE: Tibial Eminence Fracture in a Female Collegiate Basketball Player Cheri Drysdale, MEd,, ATC Margot Putukian,, MD Jeffery Bechler,, MD Princeton University How many of you have done an

More information

4/21/2017. Outline. Quadriceps inhibition post-acl injury. Stephanie Di Stasi, PT, PhD, OCS

4/21/2017. Outline. Quadriceps inhibition post-acl injury. Stephanie Di Stasi, PT, PhD, OCS Stephanie Di Stasi, PT, PhD, OCS Research Scientist, Sports Medicine Research Institute Assistant Professor, Department of Orthopaedics Outline Discuss the evidence for quadriceps activation deficits and

More information

Rehabilitation of Overhead Shoulder Injuries

Rehabilitation of Overhead Shoulder Injuries Rehabilitation of Overhead Shoulder Injuries 16 th Annual Primary Care Orthopaedic & Sports Medicine Symposium January 29, 2016 Jeremy Sherman, PT, MPT Disclosures No financial disclosures to note. Jeremy

More information

Cervical Spine Exercise and Manual Therapy for the Autonomous Practitioner

Cervical Spine Exercise and Manual Therapy for the Autonomous Practitioner Cervical Spine Exercise and Manual Therapy for the Autonomous Practitioner Eric Chaconas PT, PhD, DPT, FAAOMPT Assistant Professor and Assistant Program Director Doctor of Physical Therapy Program Eric

More information

8/8/2017. Partial Rotator Cuff Tears. Disclosures. Prevalence. Geoffrey S. Van Thiel, MD/MBA OrthoIllinois

8/8/2017. Partial Rotator Cuff Tears. Disclosures. Prevalence. Geoffrey S. Van Thiel, MD/MBA OrthoIllinois Partial Rotator Cuff Tears Geoffrey S. Van Thiel, MD/MBA OrthoIllinois Associate Professor Rush University Medical Center Associate Professor University of Illinois Team Physician US National Soccer Team

More information

THE OLDER TENNIS AND GOLF ATHLETE: INJURY MANAGEMENT AND PREVENTION

THE OLDER TENNIS AND GOLF ATHLETE: INJURY MANAGEMENT AND PREVENTION THE OLDER TENNIS AND GOLF ATHLETE: INJURY MANAGEMENT AND PREVENTION William Micheo, MD Professor and Chairman Physical Medicine, Rehabilitation, and Sports Medicine Department University of Puerto Rico

More information

Rehabilitation for MDI in the Female Athlete. John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS

Rehabilitation for MDI in the Female Athlete. John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS Rehabilitation for MDI in the Female Athlete John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS Disclosure No relevant financial relationship exists Session Learning Objectives Discuss etiology

More information

OBJECTIVES. Therapists Management of Shoulder Instability SHOULDER STABILITY SHOULDER STABILITY WHAT IS SHOULDER INSTABILITY? SHOULDER INSTABILITY

OBJECTIVES. Therapists Management of Shoulder Instability SHOULDER STABILITY SHOULDER STABILITY WHAT IS SHOULDER INSTABILITY? SHOULDER INSTABILITY Therapists Management of Shoulder Instability Brian G. Leggin, PT, DPT, OCS Lead Therapist, Penn Therapy and Fitness at Valley Forge Adjunct Assistant Professor, Department of Orthopaedics, University

More information

Management of Shoulder Pain in Persons with SCI

Management of Shoulder Pain in Persons with SCI www.fisiokinesiterapia.biz Management of Shoulder Pain in Persons with SCI Research Program Development from a Clinical Perspective Identification of the problem Identification of potential cause Development

More information

Dr. Denard s Rehabilitation Protocols Arthroscopic Shoulder Surgery

Dr. Denard s Rehabilitation Protocols Arthroscopic Shoulder Surgery 2780 E. Barnett Rd Medford, OR 97530 541-779-6250 Dr. Denard s Rehabilitation Protocols Arthroscopic Shoulder Surgery These rehabilitation protocols are based on current studies detailing healing time

More information

Phase I : Immediate Postoperative Phase- Protected Motion. (0-2 Weeks)

Phase I : Immediate Postoperative Phase- Protected Motion. (0-2 Weeks) Phase I : Immediate Postoperative Phase- Protected Motion (0-2 Weeks) Appointments Progression Criteria 2 weeks after surgery Rehabilitation appointments begin within 7-10 days of surgery, continue 1-2

More information

Post-op / Pre-op Page (ALREADY DONE)

Post-op / Pre-op Page (ALREADY DONE) Post-op / Pre-op Page (ALREADY DONE) We offer individualized treatment plans based on your physician's recommendations, our evaluations, and your feedback. Most post-operative and preoperative rehabilitation

More information

The examination of the painful knee. Maja K Artandi, MD, FACP Clinical Associate Professor of Medicine Stanford University

The examination of the painful knee. Maja K Artandi, MD, FACP Clinical Associate Professor of Medicine Stanford University The examination of the painful knee Maja K Artandi, MD, FACP Clinical Associate Professor of Medicine Stanford University Objectives of the talk By the end of this talk you will know The important anatomy

More information

Goals and Objectives for the Orthopaedic Surgery Resident McGill Orthopaedic Sports Medicine and Minimally Invasive (MGH & Shriners) Junior Residents

Goals and Objectives for the Orthopaedic Surgery Resident McGill Orthopaedic Sports Medicine and Minimally Invasive (MGH & Shriners) Junior Residents Goals and Objectives for the Orthopaedic Surgery Resident McGill Orthopaedic Sports Medicine and Minimally Invasive (MGH & Shriners) Junior Residents The following document is intended to guide you in

More information

1-Apley scratch test.

1-Apley scratch test. 1-Apley scratch test. The patient attempts to touch the opposite scapula to test range of motion of the shoulder. 1-Testing abduction and external rotation( +ve sign touch the opposite scapula, -ve sign

More information

Index. Note: Page numbers of article titles are in boldface type.

Index. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A Adductor strain, 625 Agility-training lateral hurdles, 689 Ankle sprain, and lateral ligament reconstruction, complications of, 704 705

More information

LESSONS LEARNED FROM MAJOR LEAGUE BASEBALL. Thomas J. Noonan, MD Steadman Hawkins Clinic Denver

LESSONS LEARNED FROM MAJOR LEAGUE BASEBALL. Thomas J. Noonan, MD Steadman Hawkins Clinic Denver LESSONS LEARNED FROM MAJOR LEAGUE BASEBALL Thomas J. Noonan, MD Steadman Hawkins Clinic Denver 1. GIRD isn t the holy grail Morgan/ Burkhart- most important pathologic process in throwers is loss of internal

More information

26/01/17. ACL injury in handball. Treatment of acute ACL injury. Young people with old knees. Women, soccer and knee injuries. Treatment options?

26/01/17. ACL injury in handball. Treatment of acute ACL injury. Young people with old knees. Women, soccer and knee injuries. Treatment options? Treatment of acute ACL injury ACL injury in handball Professor Ewa Roos Research Unit for Musculoskeletal Function and Physiotherapy University of Southern Denmark, Odense, Denmark eroos@health.sdu.dk

More information

Rehabilitation Following Acute ACL, PCL, LCL, PL & Lateral Hamstring Repair

Rehabilitation Following Acute ACL, PCL, LCL, PL & Lateral Hamstring Repair Page 1 of 7 Rehabilitation Following Acute ACL, PCL, LCL, PL & Lateral Hamstring Repair PREOPERATIVE PHASE Goals: Diminish inflammation, swelling, and pain Restore normal range of motion (gradual knee

More information

Exercises to Correct Muscular Imbalances. presented by: Darrell Barnes, LAT, ATC, CSCS

Exercises to Correct Muscular Imbalances. presented by: Darrell Barnes, LAT, ATC, CSCS Exercises to Correct Muscular Imbalances presented by: Darrell Barnes, LAT, ATC, CSCS Objectives Review Functional Anatomy Identify physical imbalances that lead to injury and/or decrease performance

More information

Stephanie Gould Pht, Naudira Stewart P.R.T. i000

Stephanie Gould Pht, Naudira Stewart P.R.T. i000 Return to Sport After ACL in the Young Athlete Stephanie Gould Pht, Naudira Stewart P.R.T i000 The ACL epidemic In youth aged 6-18 y.o., ACL injuries occur at a rate of 130/100,000 people per year Rate

More information

Platelet-Rich Plasma Can Be Used to Successfully Treat Elbow Ulnar Collateral Ligament Insufficiency in High- Level Throwers

Platelet-Rich Plasma Can Be Used to Successfully Treat Elbow Ulnar Collateral Ligament Insufficiency in High- Level Throwers Platelet-Rich Plasma Can Be Used to Successfully Treat Elbow Ulnar Collateral Ligament Insufficiency in High- Level Throwers Am J Orthop. 2016 May;45(4):296-300 Authors: Dines JS Williams PN Elattrache

More information

SMF PCP Treatment & Referral Guideline Orthopedics Developed February 1, 2003 Revised: October, 2011

SMF PCP Treatment & Referral Guideline Orthopedics Developed February 1, 2003 Revised: October, 2011 SUTTER MEDICAL FOUNDATION (SMF) 2800 L Street, 7 th Floor Sacramento, CA 95816 SMF PCP Treatment & Referral Guideline Orthopedics Developed February 1, 2003 Revised: October, 2011 I. Shoulder Pain...Page

More information

ACL RECONSTRUCTION SPORTS REHABILITATION. Written by Bart Sas, Qatar

ACL RECONSTRUCTION SPORTS REHABILITATION. Written by Bart Sas, Qatar ACL RECONSTRUCTION PREDICTORS AND PROGNOSIS OF OUTCOME POST RECONSTRUCTION Written by Bart Sas, Qatar Injury to the anterior cruciate ligament (ACL) is arguably the most devastating injury that an athlete

More information

Exploring the Rotator Cuff

Exploring the Rotator Cuff Exploring the Rotator Cuff Improving one s performance in sports and daily activity is a factor of neuromuscular efficiency and metabolic enhancements. To attain proficiency, reaction force must be effectively

More information

Title: Five-year Follow-up of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

Title: Five-year Follow-up of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears Paper 04 Title: Five-year Follow-up of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears Authors: Teruhisa Mihata, MD, PhD 1, Thay Q. Lee, PhD 2, Akihiko Hasegawa, MD, PhD

More information

Disclaimer. Evaluation & Treatment of Shoulder and Elbow Pain in the Adult Patient. Objectives. Anatomy

Disclaimer. Evaluation & Treatment of Shoulder and Elbow Pain in the Adult Patient. Objectives. Anatomy Evaluation & Treatment of Shoulder and Elbow Pain in the Adult Patient William T. Crowe, RN-C, FNP, MSN, MBA Disclaimer! I, William T Crowe, have relevant financial relationships to be discussed, directly

More information

W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco

W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco Knee Pain And Injuries In Adults W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco Pain Control Overview Narcotics rarely necessary after 1 st 1-2

More information

RESULTS. Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients

RESULTS. Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients RESULTS Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients were excluded from the analysis. Finally, 71 patients were included in the analysis (36

More information

Rehabilitation Guidelines for Labral/Bankert Repair

Rehabilitation Guidelines for Labral/Bankert Repair Rehabilitation Guidelines for Labral/Bankert Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the Shoulder

More information

Ms. Ruth A. Delaney, MB BCh BAO, MMedSc, MRCS

Ms. Ruth A. Delaney, MB BCh BAO, MMedSc, MRCS Ms. Ruth A. Delaney, MB BCh BAO, MMedSc, MRCS Consultant Orthopaedic Surgeon, Shoulder Specialist. +353 1 5262335 ruthdelaney@sportssurgeryclinic.com Modified from the protocol developed at Boston Shoulder

More information

FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT

FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT FOUR FOUNDATIONS OF FUNCTIONAL MOVEMENT #1. Dynamic Stability Static Stability: is the ability to maintain proper alignment and muscle activation in a given joint or structure through a defined range of

More information

Accelerated Rehabilitation Following ACL-PTG Reconstruction with Medial Collateral Ligament Repair

Accelerated Rehabilitation Following ACL-PTG Reconstruction with Medial Collateral Ligament Repair Page 1 of 7 Accelerated Rehabilitation Following ACL-PTG Reconstruction with Medial Collateral Ligament Repair PREOPERATIVE PHASE Goals: Diminish inflammation, swelling, and pain Restore normal range of

More information

Anterior Stabilization of the Shoulder: Latarjet Protocol

Anterior Stabilization of the Shoulder: Latarjet Protocol Robert K. Fullick, MD 6400 Fannin Street, Suite 1700 Houston, Texas 77030 Ph.: 713-486-7543 / Fx.: 713-486-5549 Anterior Stabilization of the Shoulder: Latarjet Protocol The intent of this protocol is

More information

Medical Practice for Sports Injuries and Disorders of the Knee

Medical Practice for Sports Injuries and Disorders of the Knee Sports-Related Injuries and Disorders Medical Practice for Sports Injuries and Disorders of the Knee JMAJ 48(1): 20 24, 2005 Hirotsugu MURATSU*, Masahiro KUROSAKA**, Tetsuji YAMAMOTO***, and Shinichi YOSHIDA****

More information

FAI syndrome with or without labral tear.

FAI syndrome with or without labral tear. Case This 16-year-old female, soccer athlete was treated for pain in the right groin previously. Now has acute onset of pain in the left hip. The pain was in the groin that was worse with activities. Diagnosis

More information

Review submitted by Justin Bittner

Review submitted by Justin Bittner Azevedo et al. (2016). Pelvic Rotation in Femoroacetabular Impingment Is Decreased Compared to Other Symptomatic Hip Conditions J Orthop Sports Phys Ther, doi:10.2519/jospt.2016.6713 Review submitted by

More information

ACL Reconstruction with Hamstring Autograft Rehabilitation Protocol

ACL Reconstruction with Hamstring Autograft Rehabilitation Protocol Brennen Lucas, M.D. Advanced Orthopaedic Associates 316-631-1600 Fax: (316) 631-1674 2778 N. Webb Rd. Wichita, KS 67226 www.aoaortho.com ACL Reconstruction with Hamstring Autograft Rehabilitation Protocol

More information

Shoulder Injuries: Treatments that Work, Do Not Work, and When ENOUGH is Enough? Mark Ganjianpour, M.D. Beverly Hills, CA April 20, 2012

Shoulder Injuries: Treatments that Work, Do Not Work, and When ENOUGH is Enough? Mark Ganjianpour, M.D. Beverly Hills, CA April 20, 2012 Shoulder Injuries: Treatments that Work, Do Not Work, and When ENOUGH is Enough? Mark Ganjianpour, M.D. Beverly Hills, CA April 20, 2012 Multiaxial ball and socket Little Inherent Instability Glenohumeral

More information

DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS

DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS Lyndon B. Gross M.D. Ph.D. The Orthopedic Center of St. Louis SHOULDER PAIN Third most common musculoskeletal

More information

Knee injures in sports overview. Mohammad Razi MD Rasoul Akram university hospital Tehran

Knee injures in sports overview. Mohammad Razi MD Rasoul Akram university hospital Tehran Knee injures in sports overview Mohammad Razi MD Rasoul Akram university hospital Tehran Anatomy Anatomy Medial structures MCL POL postero-medial capsular ligament Augmented by dynamic effect of Semimembranosus

More information

Lower Extremity Sports Injuries

Lower Extremity Sports Injuries Lower Extremity Sports Injuries AAP Musculoskeletal Boot Camp Sigrid F. Wolf, MD Pediatric Sports Medicine Fellow Northwestern University Lurie Children s Hospital Disclosure I have no relevant financial

More information

Harold Schock III, MD Rotator Cuff Repair Rehabilitation Protocol

Harold Schock III, MD Rotator Cuff Repair Rehabilitation Protocol Harold Schock III, MD Rotator Cuff Repair Rehabilitation Protocol The following document is an evidence-based protocol for arthroscopic rotator cuff repair rehabilitation. The protocol is both chronologically

More information